These instruments are twenty in number such as, the Mandalagram, the Karapatram, the Vriddhipatram, the Nakhashastram, the Mudrika, the Utpalapatram, the Arddhadharam, the Suchi, the Kushapatram, the Atemukham, the Shararimukham, the Antarmukham, the Trikurchakam, the Kutharika, the Vrihimukham, the Ara, the Vetasapatrakam, the Vadisha, the Dantashanku, and the Eshani.*
* The Mandalagram measures six fingers in length and is provided with a round or circular face. The Karapatram is the same as the modern saw. The term Vriddhipatram signifies a razor. A Vriddhipatram measures seven fingers in length, the handle alone measuring five fingers. The Nakhasastram is the same as the modern nail-clipper, the blade of the instrument measuring a finger in breadth. The Utpalapatram resembles a lotus leaf in shape. The Arddhadharam (lancet) measures eight fingers' breadth in length, being one finger broad at the middle, and two fingers at the blade. The Suchi. is the same as the modern needle. The Kushapatram is so called from its resemblance to the blade of a Kusha-grass. An Atemukham resembles the bill of a bird of the Ate species. The blade of an Atemukham measures two fingers in length, the handle measuring five fingers and thus giving an entire length of seven fingers. The Shararimukham (scissors) is so-called from the resemblance of its blades to the bills of a Sharari bird and looks somewhat like a modern black-smith's clipper, the measure of its entire length being twelve fingers. The Antarmukham is semicircular in shape and is provided with a toothed edge like that of a hand-saw. The Trikurchakam (trocar) is provided with three separate blades. The intervening space between the couple of blades attached to a handle measuring five fingers in length, is equal to the width of a Vrihiseed, its entire length being eight fingers.
Of the abovesaid instruments the Mandalagram and the Karapatram should be used in incising and scraping. The Vriddhipatram, the Nakhasastram, the Mudrika, the Utpalapatram, and the Arddhadharam, should be employed in incising (Chhedanam) and excising (Bhedanam); and the Kushapatram, the Shuchi, the Atemukham, the Shararimukham, the Trikurchakam and the Antarmukham should be made use of in exudating or secreting (Visravanam.) The Kutharika, the Vrihimukham, the Ara, the Vetasapatram and the Suchi (needle) should be used in puncturing. The Vadisha and the Danta-Shanku should be used in extracting solid bodies. The Eshani (probe or director) in probing or searching the course or direction of the pus (in a suppurated part), and the Suchi (needle; should be used in suturing. Thus we have explained the eight different functions of the instruments in connection with surgical operations.
The kutharika (small, blunt axe) measures seven fingers and a half in the handle, the blade is half a finger in width and is blunted like the tooth of a cow. The Vrihimukham measures six fingers in its entire length and its top is like that of a Vrihi seed, and the edge is cut into small thornlike projections. The Ara resembles the awl of a cobbler and measures ten fingers in its entire length, the blade is wide as the seed of a sesamum and has the girth of a Durva (grass) stem. The Vetasapatram (knife) resembles the leaf of a Vetasa plant. The blade is four fingers in length, one finger in width, and is keenly edged, the handle measuring four fingers in length. The Vadisha is shaped like a modern fishing hook. The Danta-shanku (pincers for extracting teeth) somewhat resembles the Vrihimukham in shape. The face of an Eshani (probe) is like that of a Gandupada (earth-worm). 9
Now we shall deal with the mode of handling the abovesaid instruments. - The Vriddhipatram and other instruments for excising (Bhedanam) should be caught hold of at a part between the blade and the handle. In acts of scraping the Vriddhipatram and the Mandalagram should be handled with the palm of the hand slightly turned up. The instruments for secreting should be caught hold of at the roots of their blades at the time of using them, while in the case of a king, an old man, a timid or a delicate person, a child, a woman and specially in the case of a prince of the royal blood, the Trikurchakam should be used when any secreting or exudating operation would be necessary. The handle of a Vrihi-mukham should be kept concealed within the palm of the hand and the blade should be caught hold of with the thumb and the index finger (Pradeshini). The Kutharika should be first supported on the left hand and then struck with the thumb and third finger of the right. The Ara, the Karapatram and the Eshani, should be caught hold of at their roots. The rest of the surgical instruments should be grappled according to requirements.
The abovesaid instruments are shaped like things which their very names imply, as have been already described. The Nakashastram and the Eshani measure eight fingers in length. The Suchi (needle) shall be described later on. The top-ends of the Vadisha and the Danta-Shankhu (Dental pincers) are a little bent down and their faces are made to resemble sharp thorns, or the newly sprouted leaves of a barley plant. The top-end of an Eshani closely resembles the mouth of an earth-worm. The length of a Mudrika should be made equal to that of the top phalanges of the index finger (of a man of average height.) A Shararimukham measures ten fingers in length. The rest of the instruments are mostly made to measure six fingers in length.